FL Legislative Debrief: Health Care Issues

A dispute over cuts to hospitals is one of the reasons Florida lawmakers had to postpone their final votes on the new state budget to this week. It was finally approved and sent to Governor Rick Scott, where its future is uncertain. Health News Florida's Stephanie Colombini talks about those hospital cuts and other key health issues this session with Kathleen McGrory, health reporter for the Tampa Bay Times.

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MCGRORY: State hospitals shouldered $521 million in cuts. The cut was primarily to supplemental money that was used for the Medicaid program. These cuts are going to be deepest at hospitals that take a large number of Medicaid patients. Remember that Medicaid patients are largely low-income kids and pregnant women, so it’s hospitals that serve the most vulnerable populations that are going to shoulder the biggest cuts.

However, lawmakers have pointed out that the Trump administration has offered Florida $1.5 billion for what’s known as the Low Income Pool, and that’s a pot of federal money that helps hospitals pay for charity care. What’s left the hospitals with so many questions, though, is that it’s not really clear how much of that money Florida is going to take or how it’s going to be distributed. So it’s kind of a waiting game at this point.

COLOMBINI: Some of the bills that didn’t make the budget would have eased restrictions on opening new hospitals and new trauma centers in the state.

MCGRORY: Yes, one of those issues centered on the state’s Certificate of Need process that requires hospitals to demonstrate a need for a new facility before they start building it. The House said that this is an antiquated process, and that really it should be the free market that determines whether or not a new hospital should be built, so they were actually pushing to repeal the entire process.

Similarly, the House also wanted to lift the cap on trauma centers. Well the hospitals fought that, on the grounds of having too many of these things would dilute the number of patients, and that that would actually hurt patient outcomes. The Senate is a much more moderate body than the House right now that’s a little friendlier to hospitals, so the Senate didn’t really take action on either of these issues and really prevented either from becoming law.

COLOMBINI: Florida voters overwhelmingly approved Amendment 2 in the November election to expand the state’s medical marijuana program. Even the state’s Department of Health had said earlier this year that it welcomed the legislature implementing that amendment, but lawmakers just could not agree on how to do it.

MCGRORY: You are totally right. The House and Senate both went into the session saying that they recognized that this was one of their biggest charges; that they needed to do something. There were weeks and weeks of negotiations, but the talks really broke down in the final hours. The sticking point was over the number of dispensaries that each medical marijuana grower could open. The Senate wanted to limit the number of storefronts to five per grower, but the House didn’t want there to be any caps, again it was this idea of a free market.

This now goes to the state Department of Health, so the DOH will have to write the rules. But remember the Department of Health has had problems with this before. When the initial medical marijuana law was passed, the department set up a lottery system for figuring out who could be involved in the medical marijuana world. They ended up getting sued and they had to go back to the drawing board and come up with a competitive process, so this isn’t necessarily going to be an easy thing for them to do.

COLOMBINI: I’m guessing patients are not happy right now.

MCGRORY: No they’re really not happy, and John Morgan, the Orlando trial lawyer who really bankrolled the Amendment 2 campaign, has called for the legislature to be brought back to Tallahassee for a special session. He thinks if the Department of Health handles this on its own, we’re going to see fewer licensed growers and less access for patients.

COLOMBINI: Do you see a special session being a realistic possibility?

MCGRORY: I don’t know. Times/Herald reporters asked Governor Scott if he had any intention of calling a special session. He said his office was “reviewing the options,” but I would be surprised.

COLOMBINI: Do you foresee lawsuits down the line?

MCGRORY: I foresee many lawsuits down the line, this has been a very litigious issue.

Unable to bridge a gap over how many marijuana dispensaries the state should have, Florida lawmakers Friday failed to pass legislation that would have created a framework to carry out a constitutional amendment legalizing medical marijuana for wide variety of patients.